Revenue Cycle and Payer News 5-16-2018

Hint Health Raises $10MM to Power the Direct Care Revolution
Every year we waste a trillion dollars on healthcare, roughly NASA’s inflation adjusted budget since inception. According to Zak Holdsworth, the co-founder and CEO of San Francisco-based Hint Health (@HintHealth), “the solutions to this crisis exist, they just need to be scaled.” Since late 2013, the Hint team has been quietly building a solution that gives these organizations the administrative power of a health plan. Now with thousands of doctors and hundreds of millions in payments running through their platform, the company announced it has secured $10 million in Series A financing to continue expanding operations. Led by AXA Venture Partners who is joining the board, investors include Webb Investment Network, Draper Associates, and healthcare funds Springrock Ventures, Meridian Street Capital, Launchpad Digital Health, and Tom Williams.

Humana Reports First Quarter 2018 Financial Results; Raises Full Year 2018 EPS Guidance
Humana Inc. (@humananews) reported consolidated pretax income and diluted earnings per common share (EPS) for the quarter ended March 31, 2018 (1Q18) versus the quarter ended March 31, 2017 (1Q17). The company has included financial measures throughout this earnings release that are not in accordance with GAAP. Management believes that these measures, when presented in conjunction with the comparable GAAP measures, are useful to both management and its investors in analyzing the company’s ongoing business and operating performance.

Anthem Reports First Quarter 2018 Results Reflecting Strong Medical Cost Performance
Anthem, Inc. (@AnthemInc) reported strong first quarter 2018 financial results and improved margins while continuing to make strategic investments in growth initiatives. Based on first quarter results and the business outlook for the remainder of the year, Anthem has increased its outlook for 2018 adjusted net earnings to be greater than $15.30* per share.

Health Care Premiums are Rising Because of Republicans, Senate Democrats Argue in Midterm Message
Newsweek reports that as premiums for the Affordable Care Act, or Obamacare, rise dramatically, Democratic leadership wants to make one thing clear: The blame lies on the right side of the aisle.Republicans made several unsuccessful attempts to repeal Obamacare in late 2017 but were able to remove its individual mandate, which required all Americans to have insurance or pay a penalty. The mandate worked to keep premium costs down by having a large number of young, healthy Americans pay in to mitigate the costs of the sick and the elderly. If cheaper alternatives are presented, and a critical mass of users leave, the program will no longer be economical.

California Nurses Push for a Single Payer Health Bill
Richmond Confidential reports most healthcare bills have a hefty price tag attached, but Senate Bill 562 may have one larger than some Californians are willing to take on—an estimated $400 billion a year, according to an analysis from the California Senate Appropriations Committee. The bill, commonly called a “single payer plan,” is being pushed by members of the California Nurses Association, which is headquartered in Oakland. Should it pass, all healthcare costs would be covered under the expansive umbrella provided by the state for all residents, regardless of employer or income.

Insurers Seeking Major Premium Hikes for Obamacare Plans in 2019
Insurance Journal reports several insurers in Maryland and Virginia are seeking double-digit percentage increases in monthly costs for individual medical plans in 2019. The largest increases are being sought by CareFirst, which wants to nearly double the amount it charges on average for one coverage option in Maryland, and raise the cost of another in Virginia by 64 percent.

Health Care Service Corporation’s 2017 Social Responsibility Report Demonstrates Commitment to Members and Communities in Action
In its 2017 Social Responsibility Report recently released, Health Care Service Corporation (@hcsc), the nation’s largest customer-owned health insurer, highlighted the work of its employees to make a positive impact in the lives of members and their communities and maintain a strong, caring, inclusive and ethical culture of excellence. The company will redouble efforts to improve insurance affordability and expand outreach in the communities it serves.

Highmark Partners with Sharecare to Provide Personalized Digital Health Solution to Members
Highmark Inc. (@Highmark) has entered into a six-year partnership with Sharecare, the digital health company helping people manage all their health in one place, to exclusively offer innovative, personalized health and wellness solutions to its employer group customers in Pennsylvania, Delaware, and West Virginia. Additionally, beginning January 1, 2019, Highmark members will have access to Sharecare’s personalized mobile and web-based platform that will help them better manage and understand their health, and provide timely and actionable steps to improve it, no matter where they are in their health journey.

5 Reasons to Join Us in San Diego for AHIP Institute & Expo 2018
Get out of the office this summer and get inspired. Join AHIP in San Diego to develop the big ideas, meet the right contacts, and get the inspiration to go home and continue to drive change in the health system. AHIP’s Institute & Expo will be held in gorgeous San Diego this June 20-22. Institute is health care’s most essential event, where professionals from around the country gather to share solid ideas and build smart partnerships on topics ranging from transforming care delivery to utilizing technology, data, and analytics. Still not sure? Check out these highlights that are bound to solidify your decision and then click the link in our Events Section to register.

Upcoming Events:

Embrace Telemedicine to Unlock its True Potential – Payers should not view telemedicine as a stand-alone product, useful for minor medical problems when a patient can’t get to a doctor. Rather, they should seek to find opportunities to integrate telemedicine into their overall clinical programs and plan design. Important factors include broadening access via telemedicine, records sharing between their telemedicine provider and brick and mortar care providers, leveraging telemedicine for chronic condition management, offering both medical and mental health options for collaborative care, and more deeply incorporating telemedicine into plan design. This webinar will look at specific opportunities to integrate telemedicine into health plan clinical offerings and plan design, leveraging experience from current and prospective programs. Specifics around cost savings will be cited where available. Where not available, inferences will be drawn around the magnitude of potential savings.

AHIP Institute and Expo 2018 – Take a few days away from the office this June and immerse yourself in creative thinking and idea sharing with health care professions from around the country. You’ll enjoy candid discussions including the good, the bad, and the ugly about ideas that are working, and ones that aren’t. You’ll have time to think, discover, and drive your organization’s success. You’ll quickly discover why Institute & Expo continues to be the essential health care event.

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